Department of Cardiology, PGIMER and Dr. Ram Manohar Lohia Hospital, Connaught Place, New Delhi, 110001, India.
Department of Cardiology, PGIMER and Dr. Ram Manohar Lohia Hospital, Connaught Place, New Delhi, 110001, India.
Indian Heart J. 2024 Jul-Aug;76(4):291-296. doi: 10.1016/j.ihj.2024.07.011. Epub 2024 Jul 26.
We aimed to assess the utility of B-type natriuretic peptide (BNP) and 6-min walk test (6 MWT) together as predictors of re-hospitalization and mortality in acute decompensated heart failure (ADHF) patients.
This prospective, observational, comparative study was conducted at a tertiary care center in India between October 2016 and March 2018. Patients (aged≥18 years) with ADHF and left ventricular systolic dysfunction were included in this study. The study group (N = 100 patients) consisted of patients undergoing a second BNP test along with the 6 MWT at the time of discharge and at 3-months of discharge. The control group (N = 100 patients) consisted of patients who did not undergo these tests at discharge and/or at 3-months of discharge. Study endpoints were re-hospitalization within 6-months, and in-patient and 6-month mortality.
Total 200 patients diagnosed with ADHF were enrolled. Mean age was 53.46 ± 10.12 years in the study group and 52.98 ± 9.88 years in the control group. ROC analysis of BNP level to predict re-hospitalization revealed AUC of 0.935 (p < 0.001) at admission, 0.915 (p < 0.001) at discharge, and 0.783 (p < 0.001) at 3-months. Similarly, at discharge, ROC analysis of 6 MWT to predict death gave AUC of 0.670 (p = 0.011), and at 3-months, it was 0.838 (p < 0.001). ROC analysis of BNP level to predict mortality showed AUC of 0.960 (p < 0.001) at admission, 0.947 (p < 0.001) after discharge, and 0.960 (p = 0.002) at 3-months.
BNP levels and 6 MWT have good prognostic utility in ADHF patients, and thus may be beneficial in making therapeutic adjustments and taking precautionary measures in these patients.
我们旨在评估 B 型利钠肽（BNP）和 6 分钟步行试验（6MWT）联合作为急性失代偿性心力衰竭（ADHF）患者再住院和死亡预测因子的效用。
这是一项在印度一家三级护理中心进行的前瞻性、观察性、对照研究，时间为 2016 年 10 月至 2018 年 3 月。该研究纳入了患有 ADHF 和左心室收缩功能障碍的年龄≥18 岁的患者。研究组（N=100 例患者）包括在出院时和出院后 3 个月进行第二次 BNP 检测和 6MWT 的患者。对照组（N=100 例患者）包括未在出院时和/或出院后 3 个月进行这些检查的患者。研究终点为 6 个月内再住院，以及住院和 6 个月死亡率。
共纳入 200 例诊断为 ADHF 的患者。研究组的平均年龄为 53.46±10.12 岁，对照组为 52.98±9.88 岁。BNP 水平预测再住院的 ROC 分析显示，入院时 AUC 为 0.935（p<0.001），出院时 AUC 为 0.915（p<0.001），出院后 3 个月 AUC 为 0.783（p<0.001）。同样，在出院时，6MWT 预测死亡的 ROC 分析得出 AUC 为 0.670（p=0.011），在出院后 3 个月时，AUC 为 0.838（p<0.001）。BNP 水平预测死亡率的 ROC 分析显示，入院时 AUC 为 0.960（p<0.001），出院后 AUC 为 0.947（p<0.001），出院后 3 个月 AUC 为 0.960（p=0.002）。
BNP 水平和 6MWT 在 ADHF 患者中有良好的预后预测价值，因此在这些患者中进行治疗调整和采取预防措施可能是有益的。
